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A real case of government healthcare…

One of my daughters became pregnant and found to everyone’s surprise she was going to have identical twins.  The news came with mixed emotions as well as difficult decisions.  This was not her first child and she, like many in the family, believes in natural childbirth without medication.  Only her first child was born in a hospital while all the others were born at home with a midwife.

She initially started seeing her midwife for prenatal visits, but when they discovered she was expecting twins the reality of government interference took hold.  The state of Arizona does not allow midwives to knowingly delivery twins, so they had to find a doctor.  They are on the state insurance, which poses it’s own challenges.  However, trying to find a doctor that not only would accept the state insurance but would also deliver twins and accept a patient at 10 weeks became almost an impossible task.  It took her a month to even obtain the booklet of doctors she requested from the state to start her search.  She went through the book and was more often turned down because the doctors no longer accepted the state insurance.  With the help of her midwife and fortunately a state employee willing to help, she was able to obtain the services of a high-risk OB team.

Through the ultrasounds they discovered the babies were identical twins, had separate bags of water but shared one placenta.  This put her in a higher risk category.  At one point during the pregnancy they determined she was experiencing twin-to-twin transfer and was then referred to a specialist.  Because of this the doctors wanted to see her 3 times a week and she underwent regular ultrasounds and non-stress tests.  During her third trimester an ultrasound indicated she actually had two placentas; that there was a division in the placenta that had not previously been noticed; the twins may not be identical.  At that time it was also revealed that she had not actual experienced twin-to-twin transfer, it was only borderline.  With only 4 weeks remaining until her due date the doctor told her she needed to find another doctor because she was now no longer considered high risk!

She took childbirth classes at the hospital she was to deliver at.  She is also a childbirth instructor so these classes were quite unnecessary from a childbirth aspect, but with this unusual pregnancy she wanted to be informed about the hospital, their procedures, as well as the special considerations in delivering twins.

During her regular doctor visits they discussed the expectations of delivery.  This resulted in a difference of opinion from the doctors and expectant parents.  The doctors believed in a medicated birth with a likely outcome of an induced labor as well as a cesarean delivery.  The parents believed in an unmedicated birth, as natural as possible, and only in an emergency to save the mother and/or babies did they want a cesarean.  They created their birth plan and the doctors made their modifications.  They were able to “negotiate” delaying an induction until 38 weeks.

She went in to labor naturally and the first baby came quickly.  They never made it to the hospital.  Labor never stopped and what seemed like a very short time later the second baby was delivered; he was a breech delivery.  Both babies were well and of good size, especially for twins (7 lbs. 14 oz. and 6 lbs. 9 oz.) with the mother and father cooperating during delivery; no one else was present.  This was a Sunday and at this point they did not want to go to the hospital because there was no need.  So they contacted one of their midwifes who came over to make sure mother and babies were okay – everyone was fine.  It also turns out the twins are identical, sharing only one placenta – the latest ultrasounds were wrong!

On Monday morning they contacted the OB doctors and told them the babies were delivered.  The parents asked if they should come in to be seen by the doctors and were told by the doctor’s office that they should come in 2 weeks.  The parents questioned this and the doctors decided they should make an appointment for that Thursday.  Everything seemed fine.

However, the parents received a call from the referring midwife indicating the doctor had issued a 911 call and told her to see the mother and babies immediately.  This second midwife came over Monday and checked everyone out – everyone was fine.

They kept their appointment on Thursday with the doctors, and again everyone was fine – or so they thought.  They expected to return to the doctor for her 6-week visit.